Revenue Cycle Specialist

Qualifications

• High School Diploma required.
• Bachelor’s Degree in finance or accounting (Preferred).
• Basic computer skills, Microsoft Excel, Outlook and Word, and accounting knowledge.
• Experience with Medicare, Medicaid, Managed Care plans and commercial payers required.
• Aptitude for using a fast-paced proactive vs. reactive approach to manage competing priorities.
• Excellent communication, interpersonal and decision making skills.
• Knowledge of Fund EZ, Awards, CORE, NAV and e-Paces is a plus.

Requirements

• Review Program Billing Sheets/EHR Systems to ensure compliance with Medicaid, Medicare and MCO policies and procedures.
• Follow-up with Programs for any incomplete claim/encounter before billing submission.
• Create Medicaid /MCO claims to submit through e-Paces/third party billing.
• Submit vouchers to State for BOCF billing on a monthly basis.
• Upload remittance and book related journal entries on a weekly basis.
• Reconcile claim denial reports on weekly basis, prepare appeals and implementation of programs to prevent future billing issues.
• Review remittance advice, work with related departments and health care providers to get claims processed and paid.
• Prepare and reconcile monthly billing reports against general ledger.
• Generate the open issue report for discussion and follow up.
• Liaise with other departments and third party vendors regarding monthly billing, collection and compliance.
• Work proactively with the billing team, to identify opportunities for productivity improvements.
• Aids in preparing for annual internal, external and regulatory financial audits.
• Perform routine and ad-hoc financial Analyses, and other duties as assigned.

Skills

• Strong understanding of healthcare billing and coding regulations.
• Proficiency in Microsoft Office Suite.
• Ability to manage multiple tasks and prioritize effectively.
• Excellent communication and interpersonal skills.
• Knowledge of Medicaid, Medicare, and managed care systems.

Benefits

• Equal Opportunity Employer.
• Health and wellness resources.
• Generous Paid Time Off (PTO).
• Professional development opportunities.

Pay

Min USD $65,000.00/Yr. Max USD $68,000.00/Yr.

Schedule

In Person